Blood test in A&E - is this standard?

[isthereaway]

YP needed 3 blood tests in A&E on Fri. Dr used needle with clear 'butterfly' shaped piece directly below needle but but blood was then drawn via needle through a very narrow flexible tube about 3/4" long before going into the standard receiving tube.
Only 1 vial was obtained, & even after quite a lot of needle waggling, 2nd & 3rd attempts in different sites no more blood was successfully drawn. Dr then divided the blood from 1st tube between 3 & said; 'hope thats enough'.
Thinking about it after, I don't remember this long thin tube before?

This is one way of taking blood. More often used in people with tricky veins, but perfectly normal method.

In my experience yes, the last one they used my feet!

I have tricky, small, deep veins. They always use a butterfly needle for me as when they don’t there is usually a lot of digging, sweating, and then other people having to try! I just say go straight for the butterfly now, and that means they usually hit the vein first time. I do usually get a bruise.

@Daschund feet?!?! I got "threatened" with that, when five different people couldn't get my veins in either arm.
(Threatened in a jokey way before anyone misunderstands)

depends what you mean by 'tube'. If you mean it was a syringe then that's completely normal. If blood was aspirated into a blood bottle using the vacutainer system and then some removed and divvied up in the others then that won't work.

YP has normal veins. It was the narrow tube that was the problem as the blood got stuck in it. Dr said it was 1st ever shift in hospital & had only done paediatric bloods before so I wondered if the long tube was a paediatric technique.
It was very stressful for YP & it failed.

I’m a nurse and yes they’re used in paeds normally or people with rubbish veins or just when they’re being kinder! We do call them butterfly needles

I've had this on several occasions, it's so that if they decide the pay need to they can leave the needle in and go back for more blood later, they just tape it down. Prevents them having to keep re-sticking.

I have terrible veins especially when I'm poorly, when I was in with a gallbladder infection a few years ago it took 11 tries to find a vein and they eventually got one in the top of my foot but only after lots of digging and I ended up with nerve damage, now if anything rubs the top of my foot I get a sharp tingling sensation run up my leg.

Into a syringe yes, into the blood tube nope. If it went into the tube blood and then was taken out the lab would know and cancel the results.

What does YP stand for?

Yep, I’m a paediatric doctor. This is how I do bloods on all children now no matter what size they are. I’m sorry your YP had a tough time.

Young person? Maybe?

@sleepyscientist - like this?

(YP = young person)

Butterfly needle into tube is fine. The decanting of blood into other tubes is not ok, different tubes have different reagents in so would they would likely not be able to test the sample.

Yes they are used for children

I think the nurse uses what method they are most comfortable with. I’ve had it with the normal cannula and with the butterfly cannula that has the long tube

Normal technique in children.

Perfectly normal, and you can decant from one tube to another depending on which you filled first/are collecting!

That's what they look like.

www.healthline.com/health/butterfly-needle

Here is an article that explains how they work and why you might use them. I prefer them really to having blood taken with a standard needle, I tend to find it more comfortable.

Normal to use butterfly needles. They are easier, more convenient and less painful for the patient. Shifting blood between blood bottles, no.

In someone with tricky veins, I prefer a butterfly needle and syringe. The butterfly is easier to manage and manouver than a conventional needle, its also easier to hold in place.
A syringe instead of a vacutainer (where you plug in the bottles and they fill by vacuum) means you control the pressure. Sometimes the pressure from the vacutainer can collapse a small vein, whereas with a syringe you can adjust the pressure. If you lose the vein, you can often readjust the needle if you've got a syringe attached, whereas the vacultainer's seal is one and done.
Once the syringe is removed, the blood is separated into the appropriate blood bottles and sent to the lab.
When doing difficult bloods, I'll know my minimum and my ideal volumes. If I'm very close to my minimum, I may gamble and send it instead of distressing someone by rebleeding.

Last week I needed bloods (only one bottle) and everyone was busy. I successfully used a butterfly and syringe on my hand (where I knew I had a lovely vein). The fact that it was my preferred method to do myself, should tell you something.

I’m a nurse. Butterfly needles are quite a bit more expensive than vacutainers and so are generally only used on kids and people with tricky veins. Still completely normal though and, generally, a much more comfortable experience. The tube is part of the collecting set; they come together as a package. Shifting blood around “may” be fine, depending on reagent/ tube colour. Have the results come back?

Thanks. I'm trying to understand why it was used / why it failed so it doesn't happen again (it was the tubing blocking that was the problem)

There’s a few reasons for this, most of which depend on why the patient is in hospital in the first place. The most likely answer is that the tube wasn’t blocking- they’re designed not to- but that the vein was collapsing due to dehydration/poor veins caused by illness. If the tube was blocking it may be that the blood was very “sticky” (illness) or clotted (again, illness). Or possibly the wrong size needle was used (green or blue?) but this seems the least likely. If this was due to illness then it’s probably just one of those things.

Yep both kids have had blood tests and had this type needle / set up. I think it’s very normal for kids